| NPI | 1871251124 |
|---|---|
| Other Name | GABRIELLE MARIE COSTOUROS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178016876) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: IL 67996) |
| Enumeration Date | 2021-12-03 |
| Last Update Date | 2022-07-07 |